Women's Sexual Dysfunction Flashcards
What are the 3 types of women’s sexual dysfunction?
- female orgasmic disorder
- female sexual interest/arousal disorder
- genito-pelvic pain/ penetration disorder
How long do symptoms have to be present for diagnosis of Female orgasmic disorder?
6 months and not related to other physical, mental, or relational problems
How long do symptoms have to be present for diagnosis of Female sexual interest/arousal disorder?
at least 6 moths of 3 of the following symptoms:
1. reduced interest in sexual activity
2. reduced sexual thoughts
3. reduced initiation/unresponsive to sexual activity
4. reduced pleasure in 75% of encounters
5. decreased response to internal/ external cues
6. reduced genital/ non-genital sensation at least 75% of the time
Diagnosis of genito-pelvic pain/penetration requires what?
At least one of the following:
1. tightening of the vaginal muscles, prohibiting penetration
2. tension, pain, or burning sensation when penetration attempted
3. lack of desire to have intercourse
4. fear of penetration pain
5. avoidance of sexual activity
What are nonpharm treatments for womens sexual dysfunction?
- open communications
- healthy lifestyle
- counseling
- lubricants
- use of device
How should local estrogen therapy be administered?
nightly x 2 weeks, then 2x/ week for maintenance
What patients is local estrogen therapy used in?
- specific symptoms of FSD in postmenopausal women
- vaginal atrophy
- can improve dyspareunia (painful intercourse)
- improve sexual desire by increase lubrication and blood flow
What role does testosterone have in FSD?
- off-label for shot-term use
- improves sexual desire in postmenopausal women
What is the MOA of Ospemifine?
selective estrogen receptor modulator (SERM)
What are indications for Ospemifine?
- moderate-severe dyspareunia
- vaginal dryness
Ospemifine
OSPHENA
What BBW does Ospemifine have?
risk of endometrial cancer and CV disease
Flibanserin
ADDYI
What is the MOA of Flibanserin?
1.mixed 5HT1A agonist/ 5HT2A antagonist
2. increase release of NE and DA and decrease 5HT in cortex
3. balance of NTs improve sexual functioning
What is the indication for Flibanserin?
hypoactive sexual desire disorder in premenopausal women
What BBWs does Flibanserin have?
- hypotension
- syncope
What interactions should patients be counseled on with Flibanserin?
- increased risk of hypotension with alcohol consumption
- wait at least 2 hours after consuming 1 or 2 standard alcoholic drinks before taking at bedtime
- SKIP dose if consumed 3+ drinks that evening
What is Flibanserin CI with?
moderate/ strong CYP 3A4 inhibitors in patients with hepatic impairment
Bremelanotide
VYLEESI
What is the MOA of Bremelanotide?
melanocortin receptor agonist
What is the indication for Bremelanotide?
hypoactive sexual desire disorder i premenopausal women
What are CIs for Bremelanotide?
1, uncontrolled HTN (can increase 6mmHg/ 3mmHg)
2. CV disease
What SEs does Bremelanotide have?
- focal hyperpigmentation
- nausea ~40%
Prasterone
INTRAROSA
What is the MOA of Prasterone?
synthetic steroid converted to active androgens and/or estrogens
What is Preasterone indicated for?
dyspareunia after menopause
What is a CI for Preasterone?
known/ suspected hx of breast cancer
